Midwife-led care confers benefits for pregnant women and their babies and is recommended.

In many parts of the world, midwives are the primary providers of care for childbearing women. Elsewhere it may be medical doctors or family physicians who have the main responsibility for care, or the responsibility may be shared. The underpinning philosophy of midwife-led care is normality and being cared for by a known and trusted midwife during labour. There is an emphasis on the natural ability of women to experience birth with minimum intervention. Some models of midwife-led care provide a service through a team of midwives sharing a caseload, often called 'team' midwifery. Another model is 'caseload midwifery', where the aim is to offer greater continuity of caregiver throughout the episode of care. Caseload midwifery aims to ensure that the woman receives all her care from one midwife or her/his practice partner. By contrast, medical-led models of care are where an obstetrician or family physician is primarily responsible for care. In shared-care models, responsibility is shared between different healthcare professionals.

The review of midwife-led care covered midwives providing care antenatally, during labour and postnatally. This was compared with models of medical-led care and shared care, and identified 11 trials, involving 12,276 women. Midwife-led care was associated with several benefits for mothers and babies, and had no identified adverse effects. The main benefits were a reduced risk of losing a baby before 24 weeks. Also during labour, there was a reduced use of regional analgesia, with fewer episiotomies or instrumental births. Midwife-led care also increased the woman's chance of being cared for in labour by a midwife she had got to know. It also increased the chance of a spontaneous vaginal birth and initiation of breastfeeding. In addition, midwife-led care led to more women feeling they were in control during labour. There was no difference in risk of a mother losing her baby after 24 weeks. The review concluded that all women should be offered midwife-led models of care.

About Me

In 1989 the birth of my first child was the start of my passion for pregnancy, birthing and babies. Initially I campaigned for improvement in maternity services as a consumer and became a childbirth educator running prenatal classes in the community. In 1991 I commenced studying at university completing a degree in nursing and followed by a graduate diploma in midwifery. I founded my business Pregnancy, Birth and Beyond in 1992. Registering as a midwife in 1997, I began working on a team midwifery program in a tertiary hospital and moved into private midwifery practice in 1999. Today, primarily, I support women birthing at home. I am passionate about midwives moving away from the hospital system and commencing private practice. It is through private midwifery practice that women will truly have continuity of care and real options for birth open to them. Part of my work now is supporting midwives taking the step into private practice. I also continue to be politically active lobbying for the rights of pregnant women and their families. I've dedicated my life to supporting families, as they move through the childbearing year.